CHAPTER THIRTY THREE REMEMBRANCE

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CHAPTER THIRTY THREE

"Mum. This is Louisa calling. How are you?"

"Lou Lou, my little girl. Oh, you know, life goes on. Felipe and I have our fusses but he takes good care of me and we always make up. What about you there? How are James and Joan? You have great kids, Lou. We had a good time last summer. But, hey, you never call me. What's going on? Is someone sick? Are the children alright?"

"We're okay, Mum. I've been having some tests and the doctor wanted me to ask you if you'd ever had breast cancer. So, have you?"

"That was so long ago. I never think about it. Yes, I had cancer in one of my breasts, well, it must be at least 10 years ago now. They did a, oh what did they call it, a lump something. You can hardly see the scar now. My tits look pretty good for an old lady. But hey, why are you asking me? You said something about tests. You don't have cancer, do you?"

"Mum, they are just doing some tests. I'll let you know what they find out, OK?"

"Louisa, I could come be with you. Do you want me to come?"

"No Mum, not now. I will let you know what happens. Tell Felipe we say hello. I'll call you when I know more. Bye, bye."

"Okay Luv, cheerio. Don't forget to call me."

It was Thursday night following our horrendous Tuesday. We had received the lab results from my biopsy late Wednesday afternoon. There were difficult days ahead, we knew, after receiving this news. Both areas of my right breast were malignant. I had feared the worst, but was still stunned by the confirming report. A couple learns to read each other. My default signal of concern and uncertainty is my lower lip in my teeth. I could read Martin's mood. He had appeared upset since Tuesday. He was much more silent than usual and when he did speak he was brief and brusque. I think yesterday's results were a confirmation of what he already believed to be the case. We were in our room following supper, which was not out usual routine. The children were in the living room watching the telly. I remember Martin's words.

"It is a time like this when one wishes he were not a physician. It's not right for me to withhold information from you, but I really want you to hear it from Mr. Boynton and the surgeon.

You do realize that you will need to have this removed surgically?"

"I feared as much Martin. Can I have a lumpectomy so my breast can be preserved?"

"I'll be honest with you. Because the cancer is multifocal they will most likely need to do a modified radical mastectomy. Let's not go into details now. William Mason is an oncological surgeon I worked with in London. He has moved to Truro to be close to his wife's aging parents and to slow down a bit. He'd become weary of the pace in London. If it were not for his being in Truro I would want us to go to London for the surgery, but William is as good as there is. I wouldn't entrust you to any less than his hands and mind. Seymour has made arrangements for us to meet with him tomorrow afternoon."

Inside I was screaming "Nooooo!" I had to hold it in as the children were downstairs. But my eyes were overflowing and Martin had to hold me. I wanted him to tell me more about what to expect, but he was hesitant to go into detail, and wanted to wait until our meeting Friday.

"Martin I was afraid Tuesday but now I'm even more fearful. What are we to do and what of the children?"

"Louisa, you're the one facing this, but we will deal with it together. Now, as for the children we need to go downstairs and explain what's happening. They need to know as their fears can be worse than the reality."

"The reality is pretty scary Martin. But I want them to go with us to Truro. They can't attend school tomorrow with this on their mind and I do not want them to be left home alone."

"Louisa, are you sure that is a sound idea?"

"It is what it is Martin. I would like to shield them, but they have no choice but to go through this with us. See if the County Arms has a suite with separate bedrooms. We can spend the night in Truro and come home on Saturday. I admit this is my head and not my heart speaking but we are not going to crawl into a cave over this. Let's go down and talk with them."

"No, no Mummy. Oh Mummy, you can't be sick." Joan was instantly in my lap with tears when we told them of our journey the next day and that I would likely have surgery for cancer.

And we all knew that journey was much more than going from Portwenn to Truro. Atypically, James was very quiet and pensive. I wish I knew what he was thinking. We told the children that they would be going with us but that they would have to remain at the hotel while we met with the doctors.

I was not as worried about this meeting as I was of the first session with Mr. Boynton. I had no doubt that the days ahead would be filled with much difficulty, but I was praying, yes praying, for a result that gave me life with my family for many years to come. Friday afternoon found us in a comfortable room at Royal Cornwall Hospital. Present were Martin and me and Mr. Boynton, the radiologist, and Martin's colleague William Mason .

Martin spoke first. "Seymour, William, thank you both for working it out to meet with us this quickly. Obviously we would like to know what our options are so we can make decisions and get on with Louisa's treatment. What are your findings and opinions?"

Mr. Boynton, the radiologist responded first, "Martin, Mrs. Ellingham, we have a good picture of what we are dealing with. I know you have seen the report, Martin. The lump you detected, Mrs. Ellingham, is malignant, but also the other area we found on ultrasound is cancerous. The technical term is infiltrating ductal adenocarcinoma or infiltrating ductal cancer. It is good that you have detected this early as the cells are quite abnormal and would be what we would term Grade Three, which means they grow more rapidly. We will need to do a sentinel lymph node biopsy which can be done during surgery. William, give us your thinking and recommendation."

"Yes, thank you. It's a pleasure to meet you Mrs. Ellingham. We could all wish it were under different circumstances, but we will deal with this head-on and work to have you back to life as you want it as soon as possible. Being multi focal, and the two areas not being in close proximity indicates a modified radical mastectomy. And I must tell you that given the risk factors in your case, Mrs. Ellingham, we believe that a bilateral mastectomy will yield the best possible results."

He stopped talking and allowed his words to carry their full weight. I had to think a moment before asking him the questions that began to flood my mind. My first one was the most obvious. "Mr. Mason, why both breasts. You only detected cancer in one, right?"

"You are correct. And this is a judgement on our part. You and your husband will have the final say. The affected breast must be removed, and soon. Given your risk factors, especially the fact that your mother had breast cancer, there is every possibility that the other breast will become infected."

"Do you think it has spread? Will I have to have chemotherapy?"

"Well, checking the sentinel lymph node in your axilla will tell us. We likely will not take out lymph nodes if they are involved but will treat them with chemotherapy. I would imagine that chemotherapy will be indicated in any case just to be certain that we've destroyed all the abnormal or cancerous cells."

I may not have been as fearful going into this meeting, but now the fear was growing in me exponentially. I spoke again. "Frankly, my mind is so overwhelmed with what you have told me I am not even certain of questions I need to ask."

Mr. Mason handed me a card. "Mrs. Ellingham this card has my personal number on it. Please call me any time you have any questions or concerns. Any time, please. I insist. One issue is the matter of reconstruction. You'll have to decide if you want to have surgery to reconstruct your breast or breasts. It certainly is not a cut-and-dried decision. There are many factors to consider. I'm sure Martin is aware of some of these. Together you can consider them and come to a decision. It could be begun at the time of the mastectomy, but I believe if you decide on reconstruction it would be wiser to do it under the care of a plastic surgeon in London to whom I would refer you."

Through all of this Martin had stared at a spot on the floor three feet in front of his chair. His expression had not changed. It was as if he were in a stoic trance, but I know he had taken in every word. It was Mr. Boynton who brought him into the discussion. "Martin, what are you thinking? Are there concerns or thoughts you want to bring to the table?"

"No, not really. Both of you have been clear as to what the situation is. It's also clear the decisions Louisa and I have to make. We'll make them by midweek as we want to schedule surgery for as soon as possible. I do trust your judgement so our way seems quite clear and will become clearer with surgery and the axilla node biopsies. Thank you for your willingness to work with us."

It was Mr. Mason who closed our conversation. "Martin and...may I call you Louisa? I've been quite clinical in my explanations and needed to be, I believe. I want you to be clear what we are dealing with. But, and this is important, to us this is more than a medical situation. Martin, you and Seymour and I are colleagues and friends. We offer you every concern and assistance that we may offer. If there is anything at all that we can do to make this easier, please tell us."

Thankfully Martin responded as I was too emotional to speak. "Thank you very much William and to you also Seymour. We'll call you the first of the week so we can proceed."

Back at the hotel we sat with James and Joan and explained to them as simply as possible what was going to take place. It was Joan again who was the responsive one but instead of querying about my surgery she said, "Mum, may we go to church Sunday so we can pray?"

"We could do that Joan, but one does not need to be in church to pray."

But Martin very forcefully said, "Joan, yes. We will attend service at St. Endellion on Sunday."

I then said, "Of course we will. If it is okay with you all, let's not talk any more about this right now. There will be much talking, but not tonight. Let's go eat supper. I have my family together and that's all that matters."

It is quite amazing that a couple in times of extreme tension come together in the most passionate intimacy. It is not thought about. It is not initiated. It simply overwhelms.

Upon returning to the hotel following supper I prepared hot chocolate in the small kitchen. We often did this in the evening after the autumn weather begins to be chilly. Afterwards we retired to our rooms. We were all emotionally exhausted. It felt as if we had done a day's work with a Portwenn fisherman. The children would probably watch the telly. Martin and I were so wiped out I think we could have fallen into bed with our clothes on and slept until morning.

We did shower and prepare for bed. Other than the drive from the hospital to the hotel, this was the first time we had been alone. I decided to resolve the issue of our beginning to discuss all the matters brought up in the meeting today.

"Martin, I'm so tired and I know you must be too. We can reason and talk more clearly with rest. Let's table all of this for the night and sleep. Alright?"

"Of course, Louisa. Of course."

With that we slipped into bed under the duvet. Early in our marriage Martin was either totally passionate, body and soul, or he simply would give me a peck on the cheek or lips when we went to sleep or he left the house. He came to learn that a good night peck is different than a good night kiss. For many years now his good night kiss has been gentle, firm and for a brief moment our lips are softly joined as one. This night was no different. We were lying, facing each other and he kissed me good night. We separated and looked into each other's eyes and he kissed me again but this time it was not brief. Suddenly we melted into each other.

Was it just the release of tension after this emotionally ladened day? Were we subconsciously fearing loss? Was it that we did not want the day to end with a medical consult on our mind?

Our faces parted again and Martin's eyes were wet. This triggered my tear ducts. He gently put his hand inside my gown and cupped my breast in his soft and gentle hand. Really it was not my breast in his hand, but my heart. How could this man ever have thought he did not deserve me? How, in fact, had I deserved such a good man? Our lips met once again and we became one in the beautiful dance that practiced lovers share.

Completely spent we simply laid holding each other. My last thoughts before we drifted into a sound and dreamless sleep were that somehow we would get through this. My worry from the day was put on the shelf. Together we would get through it.